TIMOTHY ANTHONY KISLA DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125031019

License Status

EXPIRED

Business

First Name

TIMOTHY

Middle

ANTHONY

Last Name

KISLA

Suffix

Business Name

TIMOTHY ANTHONY KISLA DO

Original Issue Date

05/09/1994

Effective Date

05/09/1994

Expiration Date

06/20/1999

City

CHICAGO

State

Zip

60615

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

09/22/2006